Physicians Choice Dialysis of Bristow LLC

Primary specialty

End-Stage Renal Disease (ESRD) Treatment Clinic/CenterTaxonomy code 261QE0700X

Legal business name

PHYSICIANS CHOICE DIALYSIS OF BRISTOW LLC

Practice address

402 S Main St
Bristow, OK 74010-3204

Phone

(610) 495-8900

Fax

(610) 495-8560

NPI assigned

Oct 15, 2011

Last updated

Feb 6, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Kelly Smith

Title

Director of Legal

Phone

(610) 495-8900

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PCD Bristow Other name

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Irfan Karim Kundi, M.D.

  • Internal Medicine Physician
  • Tulsa, OK
  • NPI 1366504128
  NPD (past)
• Bobby Koshy Muthalaly, MD

  • Nephrology Physician
  • Tulsa, OK
  • NPI 1457375586
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1318636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1423180800000",
    "number": "1518242015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 COMMERCE CT",
            "address_2": "SUITE 104",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194643483",
            "telephone_number": "610-495-8900",
            "fax_number": "610-495-8560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 S MAIN ST",
            "city": "BRISTOW",
            "state": "OK",
            "postal_code": "740103204",
            "telephone_number": "610-495-8900",
            "fax_number": "610-495-8560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS CHOICE DIALYSIS OF BRISTOW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-15",
        "last_updated": "2015-02-06",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "DIRECTOR OF LEGAL",
        "authorized_official_telephone_number": "610-495-8900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QE0700X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, End-Stage Renal Disease (ESRD) Treatment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200486820A",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PCD Bristow",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Pharmology Bristow LLC (Super H Pharmacy)
• Physicians Pathology Inc (Sandra K Dimmitt MD)
• Kaley Pieratt
• Sarah Brooke Pinson, P.A.
• Rainbow Health Care (Rainbow Health Care Community)
• Rainbow Management LLC

• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Bristow, OK
• Providers in Bristow, OK by specialty
• End-Stage Renal Disease (ESRD) Treatment Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.